Physical inactivity associated with higher risk of severe COVID-19: Study

Conclusions to this effect have recently been published in a study in the British Journal of Sport Medicine

What are the regular physical activity recommendations?

As per the US Physical Activity guidelines by Piercy KL et al, it is recommended that individuals above 18 years of age must engage in at least 150 minutes per week of moderate to vigorous physical activity.

While lack of physical activity has been identified as a risk factor for many chronic diseases including diabetes, obesity, and cardiovascular disease; there is no documentation on the effect of consistent physical activity on COVID- 19 outcomes.

The study

With this background, a study was performed by US researchers to compare hospitalisation and mortality rates, as well as intensive care unit (ICU) admissions for patients who were physically inactive, engaged in moderate activity, or were completely following the physical activity recommendations before the COVID-19 pandemic, based on the information obtained through the electronic health record (EHR) of the patients.

The researchers selected 48,440 adult COVID-19 positive patients between January 1, 2020 to October 21, 2020, who showcased at least three exercise vital sign measurements from March 19, 2018 to March 18, 2020.

They linked each patient's self-reported physical activity category (consistently inactive=0–10 min/week, some activity=11–149 min/week, consistently meeting guidelines=150+ min/week) to the risk of hospitalisation, ICU admission and death after COVID-19 diagnosis. The researchers then conducted multivariable logistic regression controlling for demographics and known risk factors to assess whether inactivity was associated with COVID-19 outcomes.

The authors found the following

Patients with COVID-19 who were consistently inactive had a greater risk of hospitalisation (OR 2.26; 95% CI 1.81 to 2.83),

• Inactivity patients also are 1.73 times higher likely have admission to the ICU (OR 1.73; 95% CI 1.18 to 2.55)
• Death risk was 2.49 times higher in inactive (OR 2.49; 95% CI 1.33 to 4.67) due to COVID-19 than patients who were consistently meeting physical activity guidelines.

The study also found that even some activity was better than inactivity.

Patients who were consistently inactive also had a greater risk of hospitalisation (OR 1.20; 95% CI 1.10 to 1.32), admission to the ICU (OR 1.10; 95% CI 0.93 to 1.29) and death (OR 1.32; 95% CI 1.09 to 1.60) due to COVID-19 than patients who were doing some physical activity.

This study was successful in proving that consistently meeting physical activity guidelines reduced the chances for hospitalisation, ICU admission and death among COVID-19 positive patients enrolled in a large integrated healthcare system.

" This was a first of its kind study to show the significance of physical activity as well as its role as a crucial risk factor in severe COVID-19 outcomes," noted the authors in their study

This study concluded that though fulfilling the US Physical Activity Guidelines provided significant benefit in COVID-19 outcomes, performing some activity also reduced the risks of progressing to severe COVID-19 outcomes, when compared to completely inactive patients.

Reference:

Sallis Robert et. al. Physical inactivity is associated with a higher risk for severe COVID-19 outcomes: a study in 48 440 adult patients. Published in the British Journal of Sports Medicine.

https://bjsm.bmj.com/content/early/2021/04/07/bjsports-2021-104080#ref-25